Adjuvant radiotherapy for endometrial cancer in a renal transplant patient - a case report

Abstract

Background: Treatment of locally advanced endometrial cancer in patients with transplanted pelvic kidney requires precautions because of its anatomical position next to target volumes. Case Presentation: We report a case of 42-year-old woman with a right renal transplant for 3 years diagnosed with endometrial cancer for which she underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Adjuvant Radiotherapy (RT) was planned through intensity modulated RT (IMRT) with 45 Gy in 25 fractions followed by vaginal brachytherapy (5 Gy × 2 sessions) . Planning with IMRT quantified a mean dose of 2 Gy and maximum dose of 10 Gy over the transplanted kidney. This dose was further reduced with a comparative plan of three-dimensional conformal RT (3DCRT), recording a mean dose of 1 Gy and maximum dose of 5 Gy to the transplanted kidney. 3DCRT plan was accepted and delivered. At 2-year follow-up, patient is disease free with normal renal function. Conclusion: In the presence of advanced techniques, 3DCRT is still a valid radiation technique to keep the critical organ dose under acceptable dose-volume constraints without compromising the target volume.